Riley, Edward Clark

Riley, Edward Clark is an individual health care provider with primary practice located at 255 North 30Th Street Ivinson Memorial Hospital, Laramie WY 82072. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Riley, Edward Clark can be contacted via phone (307) 742-2141.

Contact Information

Primary practice address
255 North 30Th Street Ivinson Memorial Hospital Laramie WY 82072
Phone: (307) 742-2141
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X DO624 Alabama
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 7932A Wyoming

Profile Details

NPI number 1902856719
LBN Legal business name Riley, Edward Clark
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 11th, 2006
Last updated Nov 13th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902856719 NPPES
Alabama Other 51045390 BLUE CROSS BLUE SHIELD
Alabama MEDICAID 009917200 BLUE CROSS BLUE SHIELD
Alabama Other 080155685 BLUE CROSS BLUE SHIELD

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